Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 25MA07688400 | NJ |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 307193 | NY |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD071927L | PA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME152687 | FL |
NPI | 1518914886 |
---|---|
Provider Name | Matthew Stuart Austin |
First Address | Philadelphia, PA 19107-4430 |
Second Address | Bensalem, PA 19020-2071 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2006 |
Last Update Date | 08/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1175701 | AETNA (01) | PA |
2313094000 | IBC (01) | PA |
6848606 | CIGNA (01) | |
I07575 | (02) |